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  • PUBLIC LAW 113–93—APR. 1, 2014

    PROTECTING ACCESS TO MEDICARE ACT OF 2014

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  • 128 STAT. 1040 PUBLIC LAW 113–93—APR. 1, 2014

    Public Law 113–93 113th Congress

    An Act To amend the Social Security Act to extend Medicare payments to physicians

    and other provisions of the Medicare and Medicaid programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) SHORT TITLE.—This Act may be cited as the ‘‘Protecting Access to Medicare Act of 2014’’.

    (b) TABLE OF CONTENTS.—The table of contents of this Act is as follows:

    Sec. 1. Short title; table of contents.

    TITLE I—MEDICARE EXTENDERS Sec. 101. Physician payment update. Sec. 102. Extension of work GPCI floor. Sec. 103. Extension of therapy cap exceptions process. Sec. 104. Extension of ambulance add-ons. Sec. 105. Extension of increased inpatient hospital payment adjustment for certain

    low-volume hospitals. Sec. 106. Extension of the Medicare-dependent hospital (MDH) program. Sec. 107. Extension for specialized Medicare Advantage plans for special needs in-

    dividuals. Sec. 108. Extension of Medicare reasonable cost contracts. Sec. 109. Extension of funding for quality measure endorsement, input, and selec-

    tion. Sec. 110. Extension of funding outreach and assistance for low-income programs. Sec. 111. Extension of two-midnight rule. Sec. 112. Technical changes to Medicare LTCH amendments.

    TITLE II—OTHER HEALTH PROVISIONS Sec. 201. Extension of the qualifying individual (QI) program. Sec. 202. Temporary extension of transitional medical assistance (TMA). Sec. 203. Extension of Medicaid and CHIP express lane option. Sec. 204. Extension of special diabetes program for type I diabetes and for Indians. Sec. 205. Extension of abstinence education. Sec. 206. Extension of personal responsibility education program (PREP). Sec. 207. Extension of funding for family-to-family health information centers. Sec. 208. Extension of health workforce demonstration project for low-income indi-

    viduals. Sec. 209. Extension of maternal, infant, and early childhood home visiting pro-

    grams. Sec. 210. Pediatric quality measures. Sec. 211. Delay of effective date for Medicaid amendments relating to beneficiary

    liability settlements. Sec. 212. Delay in transition from ICD–9 to ICD–10 code sets. Sec. 213. Elimination of limitation on deductibles for employer-sponsored health

    plans. Sec. 214. GAO report on the Children’s Hospital Graduate Medical Education Pro-

    gram. Sec. 215. Skilled nursing facility value-based purchasing. Sec. 216. Improving Medicare policies for clinical diagnostic laboratory tests.

    42 USC 1305 note.

    Protecting Access to Medicare Act of 2014.

    Apr. 1, 2014 [H.R. 4302]

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  • 128 STAT. 1041 PUBLIC LAW 113–93—APR. 1, 2014

    Sec. 217. Revisions under the Medicare ESRD prospective payment system. Sec. 218. Quality incentives for computed tomography diagnostic imaging and pro-

    moting evidence-based care. Sec. 219. Using funding from Transitional Fund for Sustainable Growth Rate

    (SGR) Reform. Sec. 220. Ensuring accurate valuation of services under the physician fee schedule. Sec. 221. Medicaid DSH. Sec. 222. Realignment of the Medicare sequester for fiscal year 2024. Sec. 223. Demonstration programs to improve community mental health services. Sec. 224. Assisted outpatient treatment grant program for individuals with serious

    mental illness. Sec. 225. Exclusion from PAYGO scorecards.

    TITLE I—MEDICARE EXTENDERS SEC. 101. PHYSICIAN PAYMENT UPDATE.

    Section 1848(d) of the Social Security Act (42 U.S.C. 1395w– 4(d)) is amended—

    (1) in paragraph (15)— (A) in the heading, by striking ‘‘JANUARY THROUGH

    MARCH OF’’; (B) in subparagraph (A), by striking ‘‘for the period

    beginning on January 1, 2014, and ending on March 31, 2014’’; and

    (C) in subparagraph (B)— (i) in the heading, by striking ‘‘REMAINING PORTION

    OF 2014 AND’’; and (ii) by striking ‘‘the period beginning on April 1,

    2014, and ending on December 31, 2014, and for’’; and

    (2) by adding at the end the following new paragraph: ‘‘(16) UPDATE FOR JANUARY THROUGH MARCH OF 2015.—

    ‘‘(A) IN GENERAL.—Subject to paragraphs (7)(B), (8)(B), (9)(B), (10)(B), (11)(B), (12)(B), (13)(B), (14)(B), and (15)(B), in lieu of the update to the single conversion factor estab- lished in paragraph (1)(C) that would otherwise apply for 2015 for the period beginning on January 1, 2015, and ending on March 31, 2015, the update to the single conver- sion factor shall be 0.0 percent.

    ‘‘(B) NO EFFECT ON COMPUTATION OF CONVERSION FACTOR FOR REMAINING PORTION OF 2015 AND SUBSEQUENT YEARS.—The conversion factor under this subsection shall be computed under paragraph (1)(A) for the period begin- ning on April 1, 2015, and ending on December 31, 2015, and for 2016 and subsequent years as if subparagraph (A) had never applied.’’.

    SEC. 102. EXTENSION OF WORK GPCI FLOOR.

    Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’. SEC. 103. EXTENSION OF THERAPY CAP EXCEPTIONS PROCESS.

    Section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) is amended—

    (1) in paragraph (5)(A), in the first sentence, by striking ‘‘March 31, 2014’’ and inserting ‘‘March 31, 2015’’; and

    (2) in paragraph (6)(A)— (A) by striking ‘‘March 31, 2014’’ and inserting ‘‘March

    31, 2015’’; and

    Time periods.

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  • 128 STAT. 1042 PUBLIC LAW 113–93—APR. 1, 2014

    (B) by striking ‘‘2012, 2013, or the first three months of 2014’’ and inserting ‘‘2012, 2013, 2014, or the first three months of 2015’’.

    SEC. 104. EXTENSION OF AMBULANCE ADD-ONS.

    (a) GROUND AMBULANCE.—Section 1834(l)(13)(A) of the Social Security Act (42 U.S.C. 1395m(l)(13)(A)) is amended by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’ each place it appears.

    (b) SUPER RURAL GROUND AMBULANCE.—Section 1834(l)(12)(A) of the Social Security Act (42 U.S.C. 1395m(l)(12)(A)) is amended, in the first sentence, by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’.

    SEC. 105. EXTENSION OF INCREASED INPATIENT HOSPITAL PAYMENT ADJUSTMENT FOR CERTAIN LOW-VOLUME HOSPITALS.

    Section 1886(d)(12) of the Social Security Act (42 U.S.C. 1395ww(d)(12)) is amended—

    (1) in subparagraph (B), in the matter preceding clause (i), by striking ‘‘in the portion of fiscal year 2014 beginning on April 1, 2014, fiscal year 2015, and subsequent fiscal years’’ and inserting ‘‘in fiscal year 2015 (beginning on April 1, 2015), fiscal year 2016, and subsequent fiscal years’’;

    (2) in subparagraph (C)(i), by striking ‘‘fiscal years 2011, 2012, and 2013, and the portion of fiscal year 2014 before’’ and inserting ‘‘fiscal years 2011 through 2014 and fiscal year 2015 (before April 1, 2015),’’ each place it appears; and

    (3) in subparagraph (D), by striking ‘‘fiscal years 2011, 2012, and 2013, and the portion of fiscal year 2014 before April 1, 2014,’’ and inserting ‘‘fiscal years 2011 through 2014 and fiscal year 2015 (before April 1, 2015),’’.

    SEC. 106. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL (MDH) PROGRAM.

    (a) IN GENERAL.—Section 1886(d)(5)(G) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended—

    (1) in clause (i), by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’; and

    (2) in clause (ii)(II), by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’. (b) CONFORMING AMENDMENTS.—

    (1) EXTENSION OF TARGET AMOUNT.—Section 1886(b)(3)(D) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is amended—

    (A) in the matter preceding clause (i), by striking ‘‘April 1, 2014’’ and inserting ‘‘April 1, 2015’’; and

    (B) in clause (iv), by striking ‘‘through fiscal year 2013 and the portion of fiscal year 2014 before April 1, 2014’’ and inserting ‘‘through fiscal year 2014 and the portion of fiscal year 2015 before April 1, 2015’’. (2) PERMITTING HOSPITALS TO DECLINE RECLASSIFICATION.—

    Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 (42 U.S.C. 1395ww note) is amended by striking ‘‘through the first 2

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